Provider Demographics
NPI:1558409912
Name:NEW STREET TREATMENT ASSOCIATES
Entity Type:Organization
Organization Name:NEW STREET TREATMENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:973-373-2010
Mailing Address - Street 1:57 NEW ST
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-2444
Mailing Address - Country:US
Mailing Address - Phone:973-373-2010
Mailing Address - Fax:973-373-1245
Practice Address - Street 1:57 NEW ST
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-2444
Practice Address - Country:US
Practice Address - Phone:973-373-2010
Practice Address - Fax:973-373-1245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000004261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0057177Medicaid